Department of Ophthalmology, 26949Centre Hospitalier Intercommunal de Créteil, Université Paris Est Créteil, France.
567932Ophthalmic Center for Imaging and Laser, Paris, France.
Eur J Ophthalmol. 2022 Sep;32(5):2810-2818. doi: 10.1177/11206721211064021. Epub 2021 Nov 30.
There is no widely accepted treatment for persistent/chronic central serous chorioretinopathy. The present study aimed to evaluate the efficacy, safety, and factors associated to treatment response to navigated micropulse laser in chorioretinopathy.
Retrospective observational case series including consecutive patients presenting with symptomatic persistent and chronic chorioretinopathy. All patients were treated with 5% navigated micropulse laser with the Navilas system (Navilas®, OD-OS GmBH, Teltwo, Germany), by overlying fluorescein angiography, indocyanine green angiography and/or spectral domain-optical coherence tomography images of visible leaking points and/or choroidal hyperpermeability/subretinal fluid to plan the laser treatment.
Thirty-nine eyes of 36 consecutive patients (29 men and 7 women, with a mean age of 51.87 years) were included. Logarithm of the minimum angle of resolution (LogMar) best-corrected visual acuity increased from 0.39 ± 0.24 at baseline to 0.24 ± 0.22 at 3 months ( < 0.0001) and to 0.20 ± 0.07 at 6 months ( < 0.0001). Subretinal fluid decreased from 166.82 ± 111.11 micron at baseline to 52.33 ± 78.97 micron ( < 0.0001) at 3 months and 34.12 ± 67.56 micron at 6 months ( < 0.0001). The presence of a hot spot on fluorescein angiography and a focal choroidal hyperpermeability on indocyanine green angiography, but not the duration of symptoms correlated significantly with the resolution of subretinal fluid at month 3 ( = 0.023 and 0.001).
Navigated micropulse laser laser treatment was found to be effective and safe for the treatment of chorioretinopathy, with significant improvement in visual and anatomical outcomes, unaccompanied by any adverse event at 3 and 6 months follow-up. Factors associated to subretinal fluid resolution may allow a better selection of likely responders to navigated micropulse laser treatment.
目前尚无广泛认可的治疗持续性/慢性中心性浆液性脉络膜视网膜病变的方法。本研究旨在评估导航微脉冲激光治疗脉络膜病变的疗效、安全性和与治疗反应相关的因素。
回顾性观察性病例系列研究，纳入了连续出现症状性持续性和慢性脉络膜病变的患者。所有患者均采用 Navilas 系统（Navilas®，OD-OS GmBH，Teltwo，德国）进行 5%导航微脉冲激光治疗，通过叠加荧光素血管造影、吲哚菁绿血管造影和/或频域光学相干断层扫描图像中的可见渗漏点和/或脉络膜高通透性/视网膜下液来规划激光治疗。
36 例连续患者的 39 只眼（29 名男性和 7 名女性，平均年龄 51.87 岁）纳入研究。最佳矫正视力的最小分辨角对数（LogMar）从基线时的 0.39±0.24 提高到 3 个月时的 0.24±0.22（ < 0.0001）和 6 个月时的 0.20±0.07（ < 0.0001）。视网膜下液从基线时的 166.82±111.11 微米减少到 3 个月时的 52.33±78.97 微米（ < 0.0001）和 6 个月时的 34.12±67.56 微米（ < 0.0001）。荧光素血管造影中的热点和吲哚菁绿血管造影中的局灶性脉络膜高通透性与 3 个月时视网膜下液的消退显著相关（ = 0.023 和 0.001），但症状持续时间与该结果无显著相关性。
导航微脉冲激光治疗对脉络膜病变是有效且安全的，可显著改善视力和解剖学结果，在 3 个月和 6 个月随访时无任何不良事件发生。与视网膜下液消退相关的因素可能有助于更好地选择可能对导航微脉冲激光治疗有反应的患者。
